atracurium

Atracurium is a non-depolarizing neuromuscular blocking agent of the benzylisoquinolinium class. It is used to facilitate endotracheal intubation and to induce skeletal muscle relaxation during surgery or mechanical ventilation[1][2][3][4]. Atracurium acts by competitively antagonizing acetylcholine at nicotinic receptors on the motor end-plate, thereby inhibiting neuromuscular transmission and causing muscle paralysis[2][5][6]. Its onset of action is intermediate (1–4 minutes), with effects lasting 20–35 minutes after intravenous administration[5]. Atracurium undergoes degradation via Hofmann elimination (a nonenzymatic process at physiological pH) and ester hydrolysis by nonspecific plasma esterases, making its elimination independent of renal or hepatic function[4][8]. This property makes it particularly useful in patients with hepatic or renal impairment. The drug has minimal cardiovascular effects and does not accumulate with repeated dosing. It should be administered only by clinicians experienced in the use of neuromuscular blocking agents due to risks associated with overdose or prolonged paralysis[4].

Brand names

Tracrium

Other names

atracurium besylate